A predictive model of inflammatory markers and patient-reported symptoms for cachexia in newly diagnosed pancreatic cancer patients.
Background: Cachexia is a frequent manifestation of pancreatic cancer, can limit a patient's ability to take chemotherapy, and is associated with shortened survival. We developed a model to predict the early onset of cachexia in advanced pancreatic cancer patients.Methods: Patients with newly diagno...
| Publicado en: | Supportive Care in Cancer Vol. 25; no. 6; pp. 1809 - 1818 |
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| Autores principales: | , , , , , , , , , , , , , , , |
| Formato: | research Journal Article |
| Publicado: |
Springer Nature
Jun2017
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| Acceso en línea: | Ver este registro en EBSCOhost |
| fields | @attributes: recordID: 1 pdfLink: plink: https://search.ebscohost.com/login.aspx?direct=true&db=ccm&AN=122654489&site=ehost-live header: @attributes: shortDbName: ccm uiTerm: 122654489 longDbName: CINAHL Complete uiTag: AN controlInfo: bkinfo: dissinfo: jinfo: jid: 09414355 O1J jtl: Supportive Care in Cancer issn: 09414355 maglogo: N pubinfo: dt: Jun2017 vid: 25 iid: 6 pid: 237 pub: Springer Nature place: New York, New York artinfo: ui: 122654489 122654489 144013205 NLM28111717 122654489 10.1007/s00520-016-3553-z NLM28111717 122654489 ppf: 1809 ppct: 9 formats: fmt: @attributes: type: P tig: atl: A predictive model of inflammatory markers and patient-reported symptoms for cachexia in newly diagnosed pancreatic cancer patients. aug: au: Fogelman, David Morris, J. Xiao, L. Hassan, M. Vadhan, S. Overman, M. Javle, S. Shroff, R. Varadhachary, G. Wolff, R. Vence, L. Maitra, A. Cleeland, C. Wang, X. Fogelman, David R Wang, X S affil: Department of Gastrointestinal Medical Oncology , M.D. Anderson Cancer Center , 1515 Holcombe Blvd Unit 426 Houston 77030 USA sug: subj: Cachexia Blood Pancreatic Neoplasms Complications Cytokines Blood Inflammation Blood Aged Pancreatic Neoplasms Pathology Middle Age Female Male Adult Aged, 80 and Over Funding Source Clinical Assessment Tools Human Aged: 65+ years Middle Aged: 45-64 years Adult: 19-44 years Aged, 80 & over Female Male ab: Background: Cachexia is a frequent manifestation of pancreatic cancer, can limit a patient's ability to take chemotherapy, and is associated with shortened survival. We developed a model to predict the early onset of cachexia in advanced pancreatic cancer patients.Methods: Patients with newly diagnosed, untreated metastatic or locally advanced pancreatic cancer were included. Serum cytokines were drawn prior to therapy. Patient symptoms were recorded using the M.D. Anderson Symptom Inventory (MDASI). Our primary endpoint was either 10% weight loss or death within 60 days of the start of therapy.Results: Twenty-seven of 89 patients met the primary endpoint (either having lost 10% of body weight or having died within 60 days of the start of treatment). In a univariate analysis, smoking, history symptoms of pain and difficulty swallowing, high levels of MK, CXCL-16, IL-6, TNF-a, and low IL-1b all correlated with this endpoint. We used recursive partition to fit a regression tree model, selecting four of 26 variables (CXCL-16, IL-1b, pain, swallowing difficulty) as important in predicting cachexia. From these, a model of two cytokines (CXCL-16 > 5.135 ng/ml and IL-1b < 0.08 ng/ml) demonstrated a better sensitivity and specificity for this outcome (0.70 and 0.86, respectively) than any individual cytokine or tumor marker.Conclusions: Cachexia is frequent in pancreatic cancer; one in three patients met our endpoint of 10% weight loss or death within 60 days. Inflammatory cytokines are better than conventional tumor markers at predicting this outcome. Recursive partitioning analysis suggests that a model of CXCL-16 and IL-1B may offer a better ability than individual cytokines to predict this outcome. pubtype: Academic Journal doctype: research Journal Article ougenre: Article language: English refInfo: holdings: @attributes: islocal: N |
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